Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?
Abstract Background In contrast to adults, for whom guidelines on the cholelithiasis treatment exist, there is no consistent treatment of pediatric patients with cholelithiasis throughout national and international departments, most probably due to the lack of evidence-based studies. Methods We eval...
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-021-01772-y |
| _version_ | 1818607359543476224 |
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| author | Sonja Diez Hanna Müller Christel Weiss Vera Schellerer Manuel Besendörfer |
| author_facet | Sonja Diez Hanna Müller Christel Weiss Vera Schellerer Manuel Besendörfer |
| author_sort | Sonja Diez |
| collection | DOAJ |
| description | Abstract Background In contrast to adults, for whom guidelines on the cholelithiasis treatment exist, there is no consistent treatment of pediatric patients with cholelithiasis throughout national and international departments, most probably due to the lack of evidence-based studies. Methods We evaluated the German management of pediatric cholelithiasis in a dual approach. Firstly, a retrospective, inter-divisional study was established, comparing diagnostics and therapy of patients of the pediatric surgery department with the management of patients aged < 25 years of the visceral surgery department in our institution over the past ten years. Secondarily, a nation-wide online survey was implemented through the German Society of Pediatric Surgery. Results Management of pediatric patients with cholelithiasis was primarily performed by pediatricians in the retrospective analysis (p < 0.001). Pediatric complicated cholelithiasis was not managed acutely in the majority of cases with a median time between diagnosis and surgery of 22 days (range 4 days–8 months vs. 3 days in visceral surgery subgroup (range 0 days–10 months), p = 0.003). However, the outcome remained comparable. The hospital’s own results triggered a nation-wide survey with a response rate of 38%. Primary pediatric medical management of patients was confirmed by 36 respondents (71%). In case of acute cholecystitis, 22% of participants perform a cholecystectomy within 24 h after diagnosis. Open questions revealed that complicated cholelithiasis is managed individually. Conclusions The management of pediatric cholelithiasis differs between various hospitals and between pediatricians and pediatric surgeons. Evidence-based large-scale population studies as well as a common guideline may represent very important tools for treating this increasing diagnosis. |
| first_indexed | 2024-12-16T14:25:30Z |
| format | Article |
| id | doaj.art-69bc2629fd9943f8a6ba49c2fc281e9b |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-16T14:25:30Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-69bc2629fd9943f8a6ba49c2fc281e9b2022-12-21T22:28:23ZengBMCBMC Gastroenterology1471-230X2021-04-0121111010.1186/s12876-021-01772-yCholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?Sonja Diez0Hanna Müller1Christel Weiss2Vera Schellerer3Manuel Besendörfer4Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Pediatric Surgery, Department of Surgery, University Hospital ErlangenFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Neonatology and Intensive Care Unit, Children’s Hospital Erlangen, University Hospital ErlangenRuprecht-Karls-Universität Heidelberg, Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg UniversityFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Pediatric Surgery, Department of Surgery, University Hospital ErlangenFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Pediatric Surgery, Department of Surgery, University Hospital ErlangenAbstract Background In contrast to adults, for whom guidelines on the cholelithiasis treatment exist, there is no consistent treatment of pediatric patients with cholelithiasis throughout national and international departments, most probably due to the lack of evidence-based studies. Methods We evaluated the German management of pediatric cholelithiasis in a dual approach. Firstly, a retrospective, inter-divisional study was established, comparing diagnostics and therapy of patients of the pediatric surgery department with the management of patients aged < 25 years of the visceral surgery department in our institution over the past ten years. Secondarily, a nation-wide online survey was implemented through the German Society of Pediatric Surgery. Results Management of pediatric patients with cholelithiasis was primarily performed by pediatricians in the retrospective analysis (p < 0.001). Pediatric complicated cholelithiasis was not managed acutely in the majority of cases with a median time between diagnosis and surgery of 22 days (range 4 days–8 months vs. 3 days in visceral surgery subgroup (range 0 days–10 months), p = 0.003). However, the outcome remained comparable. The hospital’s own results triggered a nation-wide survey with a response rate of 38%. Primary pediatric medical management of patients was confirmed by 36 respondents (71%). In case of acute cholecystitis, 22% of participants perform a cholecystectomy within 24 h after diagnosis. Open questions revealed that complicated cholelithiasis is managed individually. Conclusions The management of pediatric cholelithiasis differs between various hospitals and between pediatricians and pediatric surgeons. Evidence-based large-scale population studies as well as a common guideline may represent very important tools for treating this increasing diagnosis.https://doi.org/10.1186/s12876-021-01772-yPediatric gallstonesCholecystitisSymptomatic cholecystolithiasis |
| spellingShingle | Sonja Diez Hanna Müller Christel Weiss Vera Schellerer Manuel Besendörfer Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? BMC Gastroenterology Pediatric gallstones Cholecystitis Symptomatic cholecystolithiasis |
| title | Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? |
| title_full | Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? |
| title_fullStr | Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? |
| title_full_unstemmed | Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? |
| title_short | Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons? |
| title_sort | cholelithiasis and cholecystitis in children and adolescents does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons |
| topic | Pediatric gallstones Cholecystitis Symptomatic cholecystolithiasis |
| url | https://doi.org/10.1186/s12876-021-01772-y |
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